Highlights the diagnostic challenge of acute aortic dissection when presenting atypically without pain, manifesting instead as acute ischemic stroke and multiple organ failure.
Consider aortic dissection in painless stroke with organ failure; case reports leave open systematic diagnostic protocols.
Acute aortic dissection is an uncommon, life-threatening catastrophe, and early diagnosis is essential for the best chance of survival. Although acute onset of severe chest or back pain is the most common presenting symptom, some patients might present with atypical symptoms and findings such as acute stroke and mesenteric ischaemia related to the involving arterial segment. Establishing the diagnosis of aortic dissection can be difficult in the presence of atypical symptoms, especially in the absence of pain. Here, we report a case of acute, painless aortic dissection presenting with multiple organ failure and neurological deficits suggesting acute ischaemic stroke.
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Demircan et al. (2011) studied this question.
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